Stent graft transport device

ABSTRACT

A stent graft transport device includes a mounted state keeping wire that keeps a mounted state of a stent graft on a transport tube or a contracted state keeping wire that keeps a contracted state of the stent graft. The transport tube can be separated from the stent graft by pulling an operation end part of the mounted state keeping wire, and the stent graft can be in an expanded state by pulling an operation end part of the contracted state keeping wire. Furthermore, the operation end part of each of the wires is housed inside the transport tube. In order to draw the operation end part, a wire pulling-out string is provided, one end part of which is mounted on the mounted state keeping wire and the other end part of which is pulled out from a window arranged on a side peripheral surface of the transport tube.

FIELD OF THE ART

This invention relates to an artificial blood vessel transport devicethat transports and indwells an artificial blood vessel such as a stentgraft to a desired position.

BACKGROUND ART

Recently, as shown in the patent document 1, a stent graft comprising amain tube and a branch tube that branches from the main tube has beendeveloped.

The stent graft having the branch tube is to be transported to andindwelled in, for example, the arch aorta and a bifurcated blood vessel(for example, the left subclavian artery) that bifurcates from the archaorta.

A process of transporting and indwelling the branched stent graft(especially a process of indwelling the branch tube) will be explainedspecifically.

The main tube is folded in a long and thin state (a contracted state)and mounted on a circumference of a first transport tube inside of whicha guide wire passes. In addition, the branch tube is also folded in along and thin state (a contracted state) and placed along the main tube,and the branched stent graft is maintained in a long and thin stateoverall.

The above-mentioned branched stent graft is housed in a sheath catheterbeforehand in a long and thin folded state. With this state kept, thesheath catheter is inserted into the blood vessel. When the sheathcatheter reaches the ventral aorta or the thoracic aorta, the branchedstent graft housed inside of the sheath catheter is pushed into theinside of the blood vessel from the sheath catheter by the use of afirst transport tube and then is transported to a bifurcated positionalong a guide wire.

With this procedure, the main tube is transported to a desired position,and it is necessary to insert the branch tube into the bifurcated bloodvessel.

Then, a second transport tube is mounted on a distal end part of thebranch tube to extend therefrom, and a distal end part of the secondtransport tube is pulled out by an operator while grasping a holdingwire that is inserted from a distal end side of the bifurcated bloodvessel. With this procedure, the second transport tube is inserted intothe bifurcated blood vessel and the branch tube is introduced into thebifurcated blood vessel accordingly. In this state, the distal end partof the second transport tube is pulled out to the outside of a body fromthe distal end side of the bifurcated blood vessel.

Meanwhile, a contracted state keeping wire to keep the branch tube in afolded state (a contracted state) and a mounted state keeping wire tokeep the branch tube in a mounted state of the branch tube on the secondtransport tube are housed in the second transport tube.

After the operator introduces the branch tube into the bifurcated bloodvessel with the above-mentioned procedure, the operator pulls and drawsout the contracted state keeping wire from the distal end part of thesecond transport tube that is pulled out to the outside of the body.With this procedure, the contracted state of the branch tube is releasedand expanded. Then, similar to this process, the operator pulls anddraws out the mounted state keeping wire from the distal end part of thesecond transport tube. With this procedure, the mounted state of thebranch tube is released. Then, the operator removes the second transporttube from the branch tube. Finally, the operator pulls out the secondtransport tube to the outside of the body and indwells the branch tubeto the inside of the bifurcated blood vessel.

PRIOR ART DOCUMENTS Patent Document

-   Patent document 1: Domestic Republication of PCT International    Publication No. 00/025847

SUMMARY OF THE INVENTION Problems to be Solved by the Invention

In the above-mentioned process, however, a task of pulling and drawingout the contracted state keeping wire and the mounted state keeping wirefrom the distal end part of the second transport tube is complicated.

For example, a window is provided on an outer peripheral surface of thesecond transport tube, the contracted state keeping wire and the mountedstate keeping wire are exposed through the window, and the contractedstate keeping wire and the mounted state keeping wire are picked up anddrawn out through the window by an operator with tweezers or the like.With this arrangement, there is a possibility that it might take timefor the operator to pick up and draw out the contracted state keepingwire and the mounted state keeping wire or the operator might cut thecontracted state keeping wire and the mounted state keeping wire in theprocess of picking them up and eventually it might take further time.This problem is common to not only the branch tube, but also a stentgraft having a similar transport arrangement.

The present claimed invention aims to solve the above-mentioned problem,and to facilitate an operation of releasing the mounted state of thestent graft on the transport tube or an operation of releasing thecontracted state of the stent graft by making it possible to simply andsecurely pull out the mounted state keeping wire that keeps the mountedstate of the stent graft on the transport tube or the contracted statekeeping wire that keeps the contracted state of the stent graft.

Means to Solve the Problems

More specifically, a stent graft transport device in accordance withthis invention is a stent graft transport device that comprises atransport tube to transport a stent graft and a mounting mechanism tomount the stent graft on the transport tube, and is so configured thatthe mounting mechanism comprises a mounted state keeping wire that keepsa mounted state of the stent graft on the transport tube, and thetransport tube can be separated from the stent graft by releasing themounted state with an operation of pulling an operation end part of themounted state keeping wire, and is characterized by that the operationend part of the mounted state keeping wire is housed inside of thetransport tube, and a mounted state keeping wire pulling-out mechanismto draw the operation end part out of the transport tube includes amounted state keeping wire pulling-out string, one end part of which ismounted on the mounted state keeping wire and the other end part ofwhich is pulled out from a mounted state keeping wire pulling-out windowarranged on a side peripheral surface of the transport tube.

In addition, a stent graft transport device in accordance with thisinvention is a stent graft transport device that comprises a transporttube to transport a stent graft and a contraction mechanism to contractthe stent graft, and is so configured that the contraction mechanismcomprises a contracted state keeping wire that keeps a contracted stateof the stent graft, and the stent graft can be in an expanded state byreleasing the contracted state of the stent graft with an operation ofpulling an operation end part of the contracted state keeping wire, andis characterized in that the operation end part of the contracted statekeeping wire is housed inside of the transport tube, and a contractedstate keeping wire pulling-out mechanism to draw the operation end partout of the transport tube comprises a contracted state keeping wirepulling-out string, one end part of which is mounted on the contractedstate keeping wire and the other end part of which is pulled out from acontracted state keeping wire pulling-out window arranged on a sideperipheral surface of the transport tube.

Effect of the Invention

In accordance with this invention, it becomes possible to simply andsecurely dismount the transport tube from the stent graft after thestent graft is indwelled in a predetermined portion of the blood vessel,or to expand the contracted stent graft at a time of indwelling thestent graft.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 is a general view of a stent graft in accordance with a firstembodiment of this invention.

FIG. 2 is a state diagram showing a final indwelled state of the stentgraft in accordance with the first embodiment.

FIG. 3 is a process view showing a process of shrinking the stent graftin accordance with the first embodiment.

FIG. 4 is a mounting state view showing a state wherein the stent graftin accordance with the first embodiment is mounted on a stent grafttransport device.

FIG. 5 is an exploded view of the stent graft transport device inaccordance with the first embodiment.

FIG. 6 is a front view and a side view showing a tubular body (a posturecontrol member) in accordance with the first embodiment.

FIG. 7 is a longitudinal sectional view of the tubular body (the posturecontrol member) in accordance with the first embodiment.

FIG. 8 is a cross sectional view showing a first transport tube, a firstengaging wire and a first control wire, all of which are placed in afirst outer tube in accordance with the first embodiment.

FIG. 9 is a perspective view showing the tubular body, the firstengaging wire and the first control wire, all of which extend from anoperator's side of the first outer tube in accordance with the firstembodiment.

FIG. 10 is a perspective view showing the tubular body, the firstengaging wire and the first control wire, all of which extend from adistal end side of the first outer tube in accordance with the firstembodiment.

FIG. 11 is a process explanatory view showing a process of mounting thestent graft on the tubular body by a first mounting mechanism inaccordance with the first embodiment.

FIG. 12 is a partial side view showing a second mounting mechanism, asecond expansion mechanism, a control wire pulling-out mechanism, and anengaging wire pulling-out mechanism in accordance with the firstembodiment.

FIG. 13 is a process explanatory view showing a process of expanding abranch tube in a contracted state by making use of the second expansionmechanism and the control wire pulling-out mechanism and a followingprocess of separating the branch tube from the second transport tube bymaking use of the second mounting mechanism and the engaging wirepulling-out mechanism in accordance with the first embodiment.

FIG. 14 is a process explanatory view showing a process of expanding thebranch tube in the contracted state by making use of the secondexpansion mechanism and the control wire pulling-out mechanism and afollowing process of separating the branch tube from the secondtransport tube by making use of the second mounting mechanism and theengaging wire pulling-out mechanism in accordance with the firstembodiment.

FIG. 15 is a process explanatory view showing a process of expanding thebranch tube in the contracted state by making use of the secondexpansion mechanism and the control wire pulling-out mechanism and afollowing process of separating the branch tube from the secondtransport tube by making use of the second mounting mechanism and theengaging wire pulling-out mechanism in accordance with the firstembodiment.

FIG. 16 is a process explanatory view showing a process of expanding thebranch tube in the contracted state by making use of the secondexpansion mechanism and the control wire pulling-out mechanism and afollowing process of separating the branch tube from the secondtransport tube by making use of the second mounting mechanism and theengaging wire pulling-out mechanism in accordance with the firstembodiment.

FIG. 17 is a process explanatory view showing a process of expanding themain tube in the contracted state by making use of the first expansionmechanism in accordance with the first embodiment.

FIG. 18 is a process explanatory view showing a process of indwellingthe stent graft in the inside of the blood vessel by making use of thestent graft transport device in accordance with the first embodiment.

FIG. 19 is a process explanatory view showing a process of indwellingthe stent graft in the inside of the blood vessel by making use of thestent graft transport device in accordance with the first embodiment.

FIG. 20 is a process explanatory view showing a process of indwellingthe stent graft in the inside of the blood vessel by making use of thestent graft transport device in accordance with the first embodiment.

FIG. 21 is a process explanatory view showing a process of indwellingthe stent graft in the inside of the blood vessel by making use of thestent graft transport device in accordance with the first embodiment.

FIG. 22 is a process explanatory view showing a process of indwellingthe stent graft in the inside of the blood vessel by making use of thestent graft transport device in accordance with the first embodiment.

FIG. 23 is a process explanatory view showing a process of indwellingthe stent graft in the inside of the blood vessel by making use of thestent graft transport device in accordance with the first embodiment.

FIG. 24 is a process explanatory view showing a process of indwellingthe stent graft in the inside of the blood vessel by making use of thestent graft transport device in accordance with the first embodiment.

FIG. 25 is a process explanatory view showing a process of indwellingthe stent graft in the inside of the blood vessel by making use of thestent graft transport device in accordance with the first embodiment.

FIG. 26 is a process explanatory view showing a process of indwellingthe stent graft in the inside of the blood vessel by making use of thestent graft transport device in accordance with the first embodiment.

FIG. 27 is a process explanatory view showing a process of indwellingthe stent graft in the inside of the blood vessel by making use of thestent graft transport device in accordance with the first embodiment.

FIG. 28 is a process explanatory view showing a process of indwellingthe stent graft in the inside of the blood vessel by making use of thestent graft transport device in accordance with the first embodiment.

FIG. 29 is a process explanatory view showing a process of indwellingthe stent graft in the inside of the blood vessel by making use of thestent graft transport device in accordance with the first embodiment.

FIG. 30 is a process explanatory view showing a process of indwellingthe stent graft in the inside of the blood vessel by making use of thestent graft transport device in accordance with the first embodiment.

FIG. 31 is a process explanatory view showing a process of indwellingthe stent graft in the inside of the blood vessel by making use of thestent graft transport device in accordance with the first embodiment.

FIG. 32 is a process explanatory view showing a process of indwellingthe stent graft in the inside of the blood vessel by making use of thestent graft transport device in accordance with the first embodiment.

FIG. 33 is a side view showing a second posture control member inaccordance with a second embodiment of this invention.

FIG. 34 is a perspective view showing the second posture control memberin accordance with the second embodiment.

FIG. 35 is a view showing a first mounting mechanism in accordance witha further different embodiment of this invention.

FIG. 36 is a cross-sectional view showing a posture control member inaccordance with a further different embodiment of this invention.

FIG. 37 is a front view showing a posture control member in accordancewith a further different embodiment of this invention.

MODE FOR EMBODYING THE INVENTION

One embodiment of this invention will be explained with reference todrawings.

A stent graft transport device 100 in accordance with this embodiment isto transport an artificial blood vessel (a stent graft 200 in thisembodiment) to a lesion part through a blood vessel and indwell theartificial blood vessel.

Before explaining the stent graft transport device 100, the stent graft200 as being an object to be transported will be briefly explained.

<Structure of the Stent Graft 200>

The stent graft 200 in accordance with this embodiment is, as shown inFIG. 1 and FIG. 2, a branched shape comprising a long and large diametermain tube 210 and a short and small diameter branch tube 220 thatbifurcates from a part of the main tube 210, and is indwelled in, forexample, the arch aorta in this embodiment.

The main tube 210 is so arranged that a distal end (an upstream end)thereof is positioned between the left subclavian artery and the leftcommon carotid artery and extends downstream while curving along thearch aorta, and a proximal end (a downstream end) thereof is positionedto locate at a downstream side of the aortic aneurysm. In addition, thebranch tube 220 bifurcates and extends from a part of the main tube 210and is inserted and arranged in the left subclavian artery.

Each of the main tube 210 and the branch tube 220 comprises a tubulargraft 201 and a stent 202 to expand the graft 201.

The graft 201 is made of, for example, a durable and having less tissuereaction resin sheet formed to be tubular, and in this embodiment,multiple number of folds (not shown in drawings) are provided beforehandalong a circumferential direction of the graft 201 so as to facilitatebending or expansion and contraction along an axis of the graft 201. Thematerial of the sheet may be, for example, a knit fabric of a fiber, anon-woven fabric, or a porous sheet. In addition, a coating treatment ofan antithrombotic material such as heparin, collagen, acetylsalicylicacid, or gelatin may be provided on a surface of the sheet constitutingthe graft 201.

The stent 202 comprises multiple circular elastic rings 202 a each ofwhich is arranged from one opening end of the graft 201 to the otheropening end thereof at predetermined intervals (at generally uniformintervals in this embodiment, however, they may not be at uniformintervals), and the stent 202 expands into a generally cylindrical shapedue to the elastic rings 202 a in a natural state. Due to thearrangement wherein each of the circular elastic rings 202 a isseparately arranged, the stent graft 200 easily bends in the axialdirection and has excellent bending performance.

The elastic ring 202 a is in a torus shape formed by an ultrafinediameter metal line (not shown in drawings) having predeterminedelasticity that is wound at multiple times (multiplex). The material ofthe elastic ring 202 a may be, for example, a metal such as stainless,tantalum, titanium, platinum, gold, tungsten, nickel-titanium, or analloy of these metals. As mentioned, with the arrangement wherein theelastic ring 202 a is made of a thin-diameter metal line that is woundat multiple times, durability is improved compared with an elastic ringmade of a single line that is wound at once. In addition, even if theelastic ring 202 a gets damaged, it is broken only partially, resultingin obtaining an effect that the function as the elastic ring 202 a willnot be lost immediately. Similar to the graft 201, the elastic ring 202a may be provided with a coating treatment of an antithrombotic materialor may be made of resin.

Other types such as a so called Z stent 202 or a mesh stent may be usedin spite of a defect of being less likely to be bent as the stent 202.

Each of the main tube 210 and the branch tube 220 having theabove-mentioned arrangement is so configured that each of the elasticrings 202 a bends in a saddle shape and accordingly the graft 201 alsotransforms so as to shrink in the radial direction when an inwardexternal force is applied from an outside in the radial direction. “In asaddle shape” in this embodiment means that the elastic ring 202 a bendsto a direction to be double-folded, as shown in FIG. 3, and thedouble-folded elastic ring 202 a is further double-folded so that aridge and a valley appear alternatively two by two.

<Explanation of the Stent Graft Transport Device 100>

Next, the stent graft transport device 100 will be explained.

The stent graft transport device 100 comprises, as shown in FIG. 4 andFIG. 5, a transport mechanism that transports the stent graft 200 thatis shrunk to have a diameter small enough to be inserted into the bloodvessel to a predetermined indwelled portion (the arch aorta and the leftsubclavian artery in this embodiment) and an expansion mechanism thatexpands the stent graft 200 that is transported to the indwelled portionby the transport mechanism form the shrunk state to the expanded state.

Each part will be explained in detail.

<Transport Mechanism>

The transport mechanism comprises, as shown in FIG. 4 and FIG. 5, a maintransport mechanism 4 that transports the contracted stent graft 200 tothe arch aorta along the guide wire 3 (a guide wire in claims) insertedinto the blood vessel and an auxiliary transport mechanism 5 thatinserts the branch tube 220 of the stent graft 200 that is transportedto the arch aorta by the main transport mechanism 4 into the leftsubclavian artery as being the bifurcated blood vessel and arranges thebranch tube 220 in the left subclavian artery.

<Main Transport Mechanism 4>

The main transport mechanism 4 comprises, as shown in FIG. 4 and FIG. 5,a tubular body 41 inside of which the guide wire 3 passes in a slidablemanner and a first mounting mechanism 42 that mounts the stent graft 200(the main tube 210 of the stent graft 200) on the tubular body 41 in aremovable manner, and is so configured that the tubular body 41 and thestent graft 200 mounted on the tubular body 41 can be transported alongthe guide wire 3 that passes the aorta.

<Tubular Body 41>

The tubular body 41 comprises, as shown in FIG. 5, FIG. 6 and FIG. 7, afirst transport tube 412 that is in a tube shape inside of which theguide wire 3 passes and a posture control member 411 that is made ofresin and mounted on a distal end part of the first transport tube 412.The stent graft 200 is externally mounted on the tubular body 41 and adistal end part of the stent graft 200 grasps the posture control member411 so that the stent graft 200 is mounted on the tubular body 41.

The posture control member 411 is long and thin, and comprises acylindrical header 411 a whose distal end part is tapered to begenerally conical and a flat mounting body 411 b that integrallyelongates from a rear end of the header 411 a. A length of a longitudedirection of the posture control member 411 is shorter than or equal toone fourth of the length of the longitude direction of the stent graft200 (the main tube 210), and shorter than that of the main tube 210.

The reason why the distal end part of the header 411 a is made to beconical is to make it possible for the posture control member 411 tosmoothly proceed in the blood vessel. On the other hand, a proximal end(a peripheral part on the proximal end surface, in this embodiment) ofthe mounting body 411 b is smoothly rounded not to be angular. This isto make it difficult for the posture control member 411 to be caught bythe blood vessel when the posture control member 411 is pulled after thestent graft 200 is indwelled.

On the other hand, the reason why the mounting body 411 b is made to beflat is to make it sure to co-rotate the main tube 210 and the posturecontrol member 411 in a state wherein a distal end opening of thecontracted main tube 210 grasps the mounting body 411 b.

In addition, since a level difference is generated between the flatmounting body 411 b and the cylindrical header 411 a so that a height ofthe level difference is set to be more than or equal to a diameter ofthe elastic ring 202 a of the main tube 210, as shown in Fig. (b), thedistal end part of the main tube 210 that grasps the mounting body 411 bhides in the level difference viewed from the front. With thisarrangement, since it is possible to inhibit the opening distal end partof the main tube 210 from getting stuck in the blood vessel duringtransporting the stent graft 200, smooth transportation can be secured.

Furthermore, as shown in FIG. 7, a through bore 411 c where the guidewire 3 is inserted is provided in a longitudinal direction of theposture control member 411. In this embodiment, a part of the throughbore 411 c where the mounting body 411 b is inserted is mainly curvedand a part where the header 411 a passes is generally straight. Then, inthis embodiment, the mounting body 411 b is a little curved to be a fanshape.

Conversely, a part of the through bore 411 c where the header 411 apasses may be slightly curved, or the entire through bore 411 c may becurved.

The first transport tube 412 comprises, as shown in FIG. 6 and FIG. 7,an inner tube 412 a and an outer tube 412 b, and is a double pipestructure wherein the inner tube 412 a projects from a distal end partof the outer tube 412 b.

The inner tube 412 a is a two-layer structure made of, for example,polyimide and PTFE, and is more elastic and easily twisted than theouter tube 412 b. Then, the posture control member 411 is connected to adistal end part of the inner tube 412 a. Specifically, the distal endpart of the inner tube 412 a is adhered to the posture control member411 in a state wherein the distal end part of the inner tube 412 apasses the through bore 411 c. A length of a part of the inner tube 412a projecting from the outer tube 412 b is set to be longer than a totallength of the posture control member 411 and the stent graft 200 mountedon the posture control member 411. As a result, the distal end of theouter tuber 412 b is separately arranged from the rear end of the stentgraft 200 rearward (operator side) so that the inner tube 412 a isexposed between the distal end of the outer tube 412 b and the rear endof the stent graft 200.

The outer tube 412 b is made of, for example, polyimide, and a rigidityof the outer tube 412 b is higher than that of the inner tube 412 a.

As shown in FIG. 7 and FIG. 9, the outer tube 412 b and the inner tube412 a are adhered to each other by an adhesive agent (AT) only on theoperator's side farther from the distal end of the outer tube 412 b,specifically, only in the vicinity of a part operated by the operator.

<First Mounting Mechanism 42>

The first mounting mechanism 42 is a mechanism to detachably mount themain tube 210 of the stent graft 200 on the tubular body 41, morespecifically on the posture control member 411.

A specific explanation is as follows.

The first mounting mechanism 42 makes use of, as shown in FIG. 6, FIG. 7and FIG. 11, a first window 421 arranged on an outer peripheral surfaceof the posture control member 411, a first engaging wire 422 insertedinto the inside of the first window 421, a plurality of first detachablestrings 423 whose proximal end part is mounted on the tubular body 41(the posture control member 411 in this embodiment), and a plurality offirst string insertion holes 424 arranged on a distal end opening edgepart of the main tube 210.

The first window 421 is formed by cutting a part of a side peripheralsurface of the header 411 a. A penetrating direction of the first window421 coincides with, as shown in FIG. 6, FIG. 7 and FIG. 11, a bendingdirection of the posture control member 411, in this embodiment,however, the penetrating direction may be orthogonal to the bendingdirection as shown in FIG. 37. If the penetrating direction isorthogonal to the bending direction as shown in FIG. 37, the opening endof the first window 421 is difficult to be directly contacted with agreater curvature side of the blood vessel, thereby reducing apossibility of hurting the blood vessel.

The first engaging wire 422 is a thin line made of metal or resin.

The first detachable string 423 is so configured that at least a ring isformed on a distal end part thereof (all are formed to be rings in thisembodiment), and a proximal end part thereof is mounted on the tubularbody 41.

Specifically explained, the proximal end part of the first detachablestring 423 is wound around the first transport tube 412 (the inner tube412 a) so as to be mounted on the first transport tube 412 thatpenetrates the first window 421, and the distal end part thereof isdrawn out to the outside through the first window 421. As anotherembodiment, the proximal end part of the first detachable string 423 maybe fixed to the posture control member 411 by an adhesive agent or thelike. In this embodiment, four first detachable strings 423 having thisarrangement are provided.

The above-mentioned first string insertion hole 424 is formed bymounting a ring-shaped string on the front end opening edge part of themain tube 210, and four first string insertion holes 424 are formed ateven intervals in this embodiment.

Next, how the tubular body 41 is mounted on the main tube 210 by the useof the first mounting mechanism 42 will be explained.

As shown in FIG. 11(a) (c), a distal end of each of the four firstdetachable strings 423 passes the first string insertion hole 424arranged at each of the four portions of the opening edge part of themain tube 210, respectively, and the ring formed on the distal end ofthe detachable string 423 that passes the first string insertion hole424 passes the first window 421 and then is hooked by the first engagingwire 422 arranged inside of the first window 421. Then the main tube 210is mounted on the posture control member 411 through the firstdetachable string 423.

In case of dismounting the main tube 210 from the posture control member411 (the tubular body 41), an operator should pull the proximal end partof the first engaging wire 422. In accordance with this operation, thedistal end of the first engaging wire 422 moves to the operator's sidefrom the first window 421 and then the ring formed on the distal end ofthe first detachable string 423 is dismounted from the first engagingwire 422 and returns to the state shown in FIG. 11(a) so that the maintube 210 is in a state of being able to be dismounted from the posturecontrol member 411 (the tubular body 41).

A number of the first detachable strings may not be the same as that ofthe first string insertion holes. For example, in a case in which fourfirst string insertion holes are provided such as the presentembodiment, the number of the first detachable strings may be less thanthat of the first string insertion holes, namely only one, and the firstdetachable string may pass all of the first string insertion holes andthen the ring formed on the distal end of the first detachable stringmay be hooked on the first engaging wire. In addition, two firstdetachable strings may be provided and each of the detachable stringsmay pass two mutually different first string insertion holes,respectively.

<The Auxiliary Transport Mechanism 5>

The auxiliary transport mechanism 5 is, as shown in FIG. 4, FIG. 5, andFIGS. 12 to 16, configured to insert and indwell the branch tube 220 inthe bifurcated blood vessel (the left subclavian artery in thisembodiment), and comprises a second transport tube 51 (corresponds tothe transport tube in claims) and a second mounting mechanism 52 todetachably mount the branch tube 220 on the second transport tube 51.

<Second Transport Tube 51>

The second transport tube 51 is a flexible tube having a small diameterwith a plurality of lumens (two lumens are illustrated in the presentembodiment; however, there may be three or more lumens), and a proximalend part of the second transport tube 51 is mounted on an opening partof the branch tube 220.

<Second Mounting Mechanism 52>

The second mounting mechanism 52 makes use of a second engaging wire 521(a mounted state keeping wire in claims) that passes inside of thesecond transport tube 51, a second window 522 arranged on an outerperipheral surface of the second transport tube 51, one or a pluralityof second detachable strings 523 (one in this embodiment) mounted on thesecond transport tube 51 and a plurality of second string insertionholes 524 (two in this embodiment) arranged at a distal end opening edgepart of the branch tube 220, and has the same principle as that of thefirst mounting mechanism 42.

More specific explanation will follow.

The second engaging wire 521 is made of a metal or a resin that can bepushed or drawn by the operator, and is inserted into one of the lumens(hereinafter called as the first lumen) of the second transport tube 51.

The second window 522 is formed by cutting part of a side surface of thesecond transport tube 51 so as to be in communication with the firstlumen, and the second engaging wire 521 that passes the first lumen isexposed from the second window 522.

The second detachable string 523 is so configured that a ring (all areformed to be rings in this embodiment) is formed at least at a distalend part thereof, and a proximal end part thereof is fixed to near thesecond window 522 (a downstream side of the second window 522 in thisembodiment) of the second transport tube 51 by an adhesive agent or thelike.

The second string insertion hole 524 is formed by mounting a stringformed to be circular at the distal end opening edge part of the branchtube 220.

In accordance with the second mounting mechanism 52 having the abovearrangement, the branch tube 220 is mounted on the second transport tube51 in the following manner.

More specifically, a distal end of each of the second detachable strings523 is inserted into and continuously passes through the second stringinsertion holes 524 arranged at two portions of the opening edge part ofthe branch tube 220. Then, the ring formed on the distal end of thesecond detachable strings 523 that is inserted into and passes througheach of the second string insertion holes 524 is inserted into andpasses through the second window 522 and then is hooked by the secondengaging wire 521 arranged inside of the second window 522. Asmentioned, the branch tube 220 is mounted on the second transport tube51 through the second detachable strings 523.

In case of dismounting the branch tube 220 from the second transporttube 51, the second engaging wire 521 is pulled. With this operation,the ring formed on the distal end of the second detachable string 523 isdismounted from the second engaging wire 521 so that the branch tube 220becomes in a state of being able to be separated from the secondtransport tube 51.

<Expansion Mechanism>

An expansion mechanism is to expand the stent graft 200 that istransported to the indwelled position in a contracted state in a radialdirection and to tightly adhere the stent graft 200 to the inside of theblood vessel. The expansion mechanism in this embodiment comprises afirst expansion mechanism 21 for the main tube 210 and a secondexpansion mechanism 22 for the branch tube 220.

<First Expansion Mechanism 21>

The first expansion mechanism 21 comprises, as shown in FIG. 4 and FIG.17, a first binding string 211 that keeps a contracted state of the maintube 210 by binding the outer circumferential surface of the main tube210 and a first control wire 212 that is made of metal or resin and thatcontrols a binding and releasing state of the first binding string 211.

The first binding string 211 is, for example, an endless annular shapeand the first binding string 211 is folded in half to be a double lineand wraps around the contracted main tube 210 such that both end partsof the two-folded first binding string 211 overlap each other at a timeof binding the main tube 210. Then the first control wire 212, being thethin wire extending in the axial direction made of metal or resin isinserted into a ring formed by the overlapped two-folded first bindingstring 211. In accordance with this arrangement, as shown in FIG. 17(a),both end parts of the first binding string 211 are prevented from beingseparated so that the main tube 210 is kept in a bound state.

Then, when the first control wire 212 is drawn out in the bound state,the bound state of the both end parts of the first binding string 2 isreleased, as shown in FIG. 17(b), so that the bound state of the maintube 210 is released.

In this embodiment, as shown in FIG. 4, a plurality of first bindingstrings 211 are intermittently provided along the axial direction of themain tube 210, and the first control wire 212 is inserted into each ofthe first binding strings 211 that bind the main tube 210.

Then, if the first control wire 212 is pulled out, all of the firstbinding strings 211 that bind the main tube 210 are released so that themain tube 210 becomes in an expanded state due to an elastic restoringforce of the stent 202 (each elastic ring 202 a).

<Second Expansion Mechanism 22>

The second expansion mechanism 22 comprises, as shown in FIGS. 12 to 16,a second binding string 221 that keeps a contracted state of the branchtube 220 by binding an outer circumferential surface of the branch tube220 and a second control wire 222 (a contracted state keeping wire inclaims) that is made of metal or resin and that controls a binding andreleasing state of the second binding string 221.

The second binding string 221 has the same configuration as that of thefirst binding string 211, so an explanation will be omitted.

The second control wire 222 is inserted into and passes another lumen(hereinafter called as a second lumen) of the second transport tube 51.A distal end part of the second control wire 222 is exposed to theoutside of the side surface bore 51 a arranged in a middle of the secondtransport tube 51 and is inserted into and passes a loop part of thesecond binding string 221 that binds the branch tube 220.

In this embodiment, both the second engaging wire 521 and the secondcontrol wire 222 are inserted into the second transport tube 51, and thewhole second engaging wire 521 is housed inside of the second transporttube 51 and the whole second control wire 222 is also housed inside ofthe second transport tube 51 except for the distal end part thereof tokeep the bound state of the branch tube 220.

The reason why at least each proximal end part of the second engagingwire 521 and the second control wire 222 is housed inside of the secondtransport tube 51 will be described later in <usage>. The reason isbecause the second transport tube 51 including an operator's end part (aproximal end part) is drawn around inside of the blood vessel during anoperation. The arrangement is to securely prevent the second controlwire 222 and the second engaging wire 521 from being unexpectedly pulledand prevent the expansion mechanism or the mounting mechanism from beingunexpectedly operated.

<Pulling-Out Mechanism>

On the other hand, if the second control wire 222 and the secondengaging wire 521 cannot be pulled out from the second transport tube51, since it is not possible to operate the second expansion mechanism22 and the second mounting mechanism 52, a pulling-out mechanism to pullout the second control wire 222 and a pulling-out mechanism to pull outthe second engaging wire 521 are provided respectively in thisembodiment.

As shown in FIGS. 12 to 16, as the pulling-out mechanism, there are acontrol wire pulling-out mechanism 6 (a contracted state keeping wirepulling-out window in claims) to pull out the second control wire 222and an engaging wire pulling-out mechanism 7 (a mounted state keepingwire pulling-out mechanism in claims) to pull out the second engagingwire 521, and both have the same principle.

The control wire pulling-out mechanism 6 comprises a control wirepulling-out window 61 (a contracted state keeping wire pulling-outwindow in claims) that is arranged in the middle (more specifically, theoperator's hand end part) of the second transport tube 51 and a veryflexible control wire pulling-out string 62 (a contracted state keepingwire pulling-out string in claims) that is tied to the second controlwire 222 and that is pulled out of the second transport tube 51 from thecontrol wire pulling-out window 61.

If the control wire pulling-out string 62 is pulled, the operator's handside of the second control wire 222 in the second transport tube 51 ispulled out from the control wire pulling-out window 61, and it ispossible to expand the branch tube 220 by pulling the pulling-out secondcontrol wire 222.

The same applies also to the engaging wire pulling-out mechanism 7. Morespecifically, the engaging wire pulling-out mechanism 7 comprises anengaging wire pulling-out window 71 (a mounted state keeping wirepulling-out window in claims) that is arranged in the middle (morespecifically, the operator's hand end part) of the second transport tube51 and that is arranged at a portion (a portion deviated in the axialdirection in this embodiment) different from the portion where thecontrol wire pulling-out window 61 is arranged and an engaging wirepulling-out string 72 (a mounted state keeping wire pulling-out stringin claims) that is tied to the second engaging wire 521 and that ispulled out of the second transport tube 51 from the engaging wirepulling-out window 61.

Although a distal end part of the control wire pulling-out string 62 anda distal end part of the engaging wire pulling-out string 72 are exposedout from the second transport tube 51, since the control wirepulling-out string 62 and the engaging wire pulling-out string 72 aremore flexible than the second control wire 222 and the second engagingwire 521 and are not loop-shaped having an open end shape, there islittle possibility that the control wire pulling-out string 62 and theengaging wire pulling-out string 72 will unexpectedly get stuck in anyportion during the operation.

<Usage>

Next, an example of transporting and indwelling the stent graft 200 bythis transport device will be explained.

First, the main tube 210 is contracted and the distal end opening of thecontracted main tube 210 holds the posture control member 411 in a statewherein the tubular body 41 is inserted into the main tube 210 of thestent graft 200, and the main tube 210 is mounted on the posture controlmember 411 by the first mounting mechanism 42.

Similar to the branch tube 220 of the stent graft 200, the branch tube220 is contracted in a state wherein the second transport tube 51 isinserted into the branch tube 220 of the stent graft 200 and the branchtube 220 is mounted on the second transport tube 51 by the secondmounting mechanism 52.

Furthermore, the guide wire 3 is inserted into the tubular body 41 (thefirst transport tube 412 and the posture control member 411), and thetubular body 41 and the stent graft 200 that is mounted on the tubularbody 41 are made to be in a state of being able to be transported alongthe guide wire 3.

In this state, as shown in FIG. 4, the posture control member 411 ismounted on the distal end part of the main tube 210 of the stent graft200 and the first transport tube 412, the first engaging wire 422 andthe first control wire 212 extend from the main tube 210, and the secondtransport tube 51 extends from the distal end of the branch tube 220. Inaddition, the distal end part of the first engaging wire 422 and thedistal end part of the first control wire 211 are, as shown in FIG. 6and FIG. 7, inserted into and pass the inside of the posture controlmember 411, and are housed in a triple lumen tube 45 arranged at adistal end part of the posture control member 411. The arrangement is toprevent a defect that these distal end parts get stuck unexpectedlyinside of the blood vessel.

In this embodiment, the tubular body 41, the first engaging wire 422,and the first control wire 212 that extend from the stent graft 200 aregathered into one piece and inserted into and pass a first outer tube T1whose diameter is larger than a diameter of the total diameter of thetubular body 41, the first engaging wire 422, and the first control wire212. In addition, as shown in FIG. 8 and FIG. 9, the first outer tube T1is so made that a reinforcing wire (GT) made of metal or resin whoserigidity is higher than that of other wire can be detachably insertedinto the first outer tube T1, and the first outer tube T1 and thetubular body 41 that are inserted into and pass the inside of the firstouter tube T1 are prevented from being buckled or contracted duringsending the stent graft 200 forward. Furthermore, in this embodiment,the tube 422 x into which the first engaging wire 422 is inserted, thetube 212 x into which the first control wire 212 is inserted, the tube(GTx) into which the reinforcing wire (GT) is inserted and the outertube 412 b are adhered to the first outer tube T1 by pouring an adhesiveagent (not shown in drawings) at a distal end part and a proximal endpart (a root part) of the first outer tube T1.

Then, the stent graft 200, the tubular body 41, the first engaging wire422, and the first control wire 212, each of which extends from thestent graft 200, (the first outer tube T1 to bind the tubular body 41,the first engaging wire 422, and the first control wire 212) and thesecond transport tube 51 are inserted into a sheath catheter T2, and asshown in FIG. 18, and only the header 411 a projects from a distal endof the sheath catheter T2 in an initial state. A check valve to preventa blood reverse flow is provided at a root portion of some tubes such asthe first outer tube T1 as necessary.

Next, as shown in FIG. 19, the sheath catheter T2 that houses the stentgraft 200 and the stent graft transport device 100 is inserted into theinside of the anterior descending artery along the guide wire 3 thatprecedingly passes in the inside of the artery.

Later, as shown in FIGS. 20 to 22, the stent graft 200 mounted on theposture control member 411 is made to project and be separated from thesheath catheter T2 and then be guided by the guide wire 3 so as to bemoved to the indwelled position by sending the first outer tube T1 andthe second transport tube 51.

During this process, at a time when the guide wire 3 passes the curvedarch aorta, the posture control member 411 naturally rotates in theaxial direction (as shown in FIGS. 20 and 21) so as to coincide thecurved direction of the posture control member 411 with the curveddirection of the arch aorta, and then a phase around the axis of theposture control member 411 is automatically adjusted to be alwaysconstant to the blood vessel.

Then, the stent graft 200 fixed to the posture control member 411 alsorotates together with the posture control member 411 and isautomatically adjusted to a predetermined rotational phase, namely afinal indwelled phase.

Then, in the final indwelled phase shown in FIG. 22, since the stentgraft 200 is mounted on the posture control member 411 beforehand so asto coincides a position of the branch tube 220 of the stent graft 200with a position of the branch artery viewed from the axial direction, itis possible to automatically coincide the phase of the branch tube 220with the phase facing to an entrance of the branch artery withoutoperating the branch tube 220 of the stent graft 200 by the operator.This is a self-alignment function.

Accordingly, it is enough for the operator just to operate the stentgraft 200 back and forth so as to locate the branch tube 200 near theentrance of the branch artery, and then it is possible for the operatorto coincide the position of the branch tube 220 with the position of thebranch artery without operating the stent graft 200 at the operator'sside so that the operability can be drastically improved compared with aconventional stent graft.

In addition, since the posture control member 411 is short and mountedonly at the distal end part of the stent graft 200 so that the posturecontrol member 411 will not hamper flexibility of the stent graft 200 asbeing a characteristic of this kind of the stent graft 200, it becomespossible to smoothly transport the stent graft 200 because it becomesdifficult to apply resistance to the stent graft 200 in the process oftransporting the stent graft 200.

Next, after the branch tube 220 is positioned near the entrance of thebranch artery, the branch tube 220 is inserted into the branch artery.This procedure is as follows.

First, the distal end of the second transport tube 51 projecting fromthe sheath catheter T2 at the operator's side is inserted into thesheath catheter T2 in a folded manner.

In order to do so, in this embodiment, first, a second outer tube T3having a bigger diameter than that of the second transport tube 51 thatextends toward the operator's side is fitted over the second transporttube 51 from the distal end thereof, and then the second outer tube T3is sent out until the distal end of the second outer tube T3 reachesnear the distal end of the branch tube 220, as shown in FIG. 23. Then,the distal end of the second transport tube 51 is folded and insertedinto the second outer tube T3 from a proximal end of the second outertube T3 and then the second transport tube 51 is sent out.

With this procedure, the distal end of the second transport tube 51projects from the distal end of the second outer tube T3, as shown inFIG. 24.

The second transport rube 51 may be folded and inserted directly intothe inside of the sheath catheter T2 without providing the second outertube T3, however, there might be a case that the folded second transporttube 51 gets stuck in the middle of the blood vessel and is difficult toproceed if the second outer tube T3 is not provided. By contrast, if thesecond outer tube T3 is inserted beforehand and the folded secondtransport tube 51 is sent forward in the second outer tube T3, it ispossible to prevent the above-mentioned problem before it happens.

On the one hand, a separately provided holding device 8 is inserted intothe branch artery from the distal end side of the branch artery. Theholding device 8 comprises a thin-diameter holding tube 81 and a holdingwire 82 that is inserted into the inside of the holding tube 81 in astate of being able to make a back and forth movement, and a ring isformed on a distal end of the holding wire 82.

Then, the holding device 8 is sent out so as to project a ring 82 aarranged at the distal end of the holding device 8 from the branchartery and the ring 82 a is positioned in the aorta.

With this state kept, the second transport tube 51 is operated so as toinsert the distal end part of the second transport tube 51 into the ring82 a, as shown in FIG. 25. The distal end part of the second transporttube 51 is made not of a tube but is a flexible line member whosediameter is smaller than that of the tube in order to facilitateinsertion of the second transport tube 51 into the ring 82 a.

Next, as shown in FIG. 26, the holding tube 81 is sent out so as tobring the distal end ring 82 a into the inside of the holding tube 81and then the distal end part of the second transport tube 51 is graspedby narrowing the distal end ring 82 a. At this time, as shown in FIG.27, the second outer tube T3 is pulled out by the operator.

Next, as shown in FIG. 28, the holding member 8 is pulled toward theoperator's side and the distal end part of the second transport tube 51grasped by the holding member 8 is taken out from the body. If thesecond transport tube 51 is further pulled, as shown in FIG. 29, thebranch tube 220 mounted on the second transport tube 51 is also pulledand inserted into and positioned at the branch artery.

As mentioned, after the main tube 210 is placed at the arch aorta andthe branch tube 220 is placed at the branch artery, the main tube 210and the branch tube 220 are expanded. A procedure to expand them is asfollows.

First, regarding the main tube 210, the first control wire 212 thatextends out of the body is pulled out from the operator's side of thesheath catheter T2. Then, as shown in FIG. 30, binding of the firstbinding string 211 is disconnected so that the main tube 210 is in theexpanded state and attaches to the inside of the aorta.

On the other hand, regarding the branch tube 220, as shown in FIG. 13,at the operator's side part of the second transport tube 51 pulled outof the body from the branch artery, the control wire pulling-out string62 that extends out of the control wire pulling-out window 61 is pulledso as to draw out the operator's side (the proximal end part) of thesecond control wire 222 from the second transport tube 51. Then, thesecond control wire 222 is pulled out. With this procedure, the bindingof the second binding string 221 is disconnected, as shown in FIG. 14and FIG. 30, so that the branch tube 220 is in the expanded state andattaches to the inside of the aorta.

Finally, only the stent graft 200 is left and the tubular body 41 andthe second transport tube 51 are pulled out from the body. A procedureis as follows.

First, regarding the main tube 210, the first engaging wire 422 thatextends out of the body from the operator's side of the sheath catheterT2 is pulled. With this procedure, as shown in FIG. 31, the firstdetachable string 423 is released from the tubular body 41 so that theconnection of the tubular body 41 and the main tube 210 is released.Later, the tubular body 41 (and the first outer tube T1) is pulled outfrom the body.

On the other hand, regarding the branch tube 220, as shown in FIG. 13,at the operator's side part of the second transport tube 51 pulled outof the body from the branch artery, the engaging wire pulling string 72that extends out of the engaging wire pulling-out window 71 is pulled soas to draw out the operator's side of the second transport tube 521 fromthe second transport tube 51. Then, as shown in FIG. 14, the secondengaging wire 521 is pulled out. With this procedure, the binding of thesecond detachable string 523 is disconnected from the second transporttube 51, as shown in FIG. 15 and FIG. 31, so that the connection betweenthe second transport tube 51 and the branch tube 220 is released. Then,the second transport tube 51 is pulled out from the body through thebranch aorta.

With this procedure, as shown in FIG. 32, the stent graft 200 isindwelled at the desired position.

The present claimed invention is not limited to the above-mentionedembodiment.

For example, if the engaging wire pulling-out string and the controlwire pulling-out string are made to have different shapes, respectively,it is possible for the operator to further reduce a possibility ofconfusing them and mistaking an order of pulling the strings. To makethe strings to have different shapes means to make a color, length, orthickness different respectively in a degree capable of determining thestring visually or by touch.

In addition, as shown in FIG. 33 and FIG. 34, one or a plurality ofsecond posture control members 413 may be fixed to the first transporttube 412 intermittently by adhesive or the like in a manner of beingunable to be rotated.

The second posture control member 413 is short (at least shorter than orequal to one fifth of the length of the main tube 210), and is shapedas, for example, a flat plate shape that is unable to be rotated aroundthe axis of the contracted stent graft 200 (the main tube 210). Athrough bore is provided at a center of the second posture controlmember 413, and the first transport tube 412 and the guide wire 3 areinserted into and past the through bore. In this embodiment, the secondposture control member 413 is a flat plate shape whose front end partand rear end part are tapered and whose diameters of both end parts aregenerally the same as the diameter of the first transport tube 412. Thereason why both ends of the second posture control member 413 aretapered is to prevent the second posture control member 413 from gettingcaught unexpectedly by the blood vessel or another member in case ofpulling out the second posture control member 413 after the stent graft200 is indwelled.

In the above-mentioned embodiment, only the distal end part of the stentgraft 200 is mounted on the posture control member 41 in a manner ofbeing unable to be rotated around the axis so that torsion might begenerated at the center part and the proximal end part of the stentgraft 200, however, if the second posture control member 413 is providedalso at the center part of the first transport tube 412, it is possibleto reduce the torsion.

In addition, the through bore of the second posture control member 413may be curved or bent, and the second posture control member 412 alsomay be provided with the self-alignment function. In this case, theposture control member 411 may be omitted.

The first transport tube 412 is so configured that the inner tube 412 aprojects from the distal end of the outer tube 412 b and the proximalend part of the first transport tube 412 is high in rigidity and thedistal end part thereof is low in rigidity (flexible) in theabove-mentioned embodiment, however, a single tube may be used. In thiscase, the rigidity in the distal end part may be made different fromthat in the proximal end part by changing a material or a knitting of afiber.

The first mounting mechanism that mounts the stent graft 200 on thefirst transport tube 412 may be as shown in FIG. 35.

More specifically, as shown in FIG. 35, the stent graft 200 is mountedon the first transport tube 412 by inserting the first engaging wire 422into a part where the first string insertion hole 424 formed on thestent graft 200 is overlapped with the ring of the first detachablestring 423 mounted on the first transport tube 412. Then, when the firstengaging wire 422 is pulled out, the engaged state of the first stringinsertion hole 424 and the first detachable string 423 is released sothat the stent graft 200 is in a state of being able to be released fromthe first transport tube 412.

A plurality of (four) the first string insertion holes 424 and aplurality of (four) the first detachable strings 423 are provided (inorder to avoid complicating the drawings, only two of them are drawn inFIG. 35), and a number of the first engaging wires 422 corresponds tothe number of the first string insertion holes 424 and the number of thefirst detachable strings 423.

In accordance with this arrangement, it becomes easier to release theengagement.

In addition, as shown in FIG. 36, the posture control member 411 mayhave an arrangement wherein two or more straight through bores 411 cwhose direction differ each other are provided in series.

Furthermore, instead of the first and second binding strings, forexample, a rectangle sheet or a mesh sheet (a binding sheet) may be madeto be tubular and the tubular sheet is mounted over the stent graft andkeeps the stent graft in the contracted state. In this case, a controlwire linearly sews an overlapped part of both end edge parts of thetubular binding sheet in order to prevent the binding sheet from beingloose.

In addition, this invention is not limited to the stent graft having asingle branch tube and a stent graft having two or more branch tubes mayproduce the same effect as that of the stent graft having one branchtube.

In addition, this invention is not limited to the above-mentionedembodiment such as the shape of the posture control member or the shapeof the second control member, and various modifications can be madewithout departing from a scope of a spirit of this invention.

EXPLANATION OF THE REFERENCE NUMERALS

-   -   200 stent graft    -   210 main tube    -   220 branch tube    -   100 stent graft transport device    -   guide wire    -   T1 first outer tube    -   T2 sheath catheter    -   T3 second outer tube    -   first expansion mechanism    -   211 first binding string    -   212 first control wire    -   22 second expansion mechanism    -   221 second binding string    -   222 second control wire (contracted state keeping wire)    -   4 main transport mechanism    -   41 tubular body    -   411 posture control member    -   411 a header    -   411 b mounting body    -   411 c through bore    -   412 first transport tube    -   412 a inner tube    -   412 b outer tube    -   42 first mounting mechanism    -   421 first window    -   422 first engaging wire    -   423 first detachable string    -   424 first string insertion hole    -   5 auxiliary transport mechanism    -   51 second transport tube (transport tube)    -   52 second mounting mechanism    -   521 second engaging wire (mounted state keeping wire)    -   522 second window    -   523 second detachable string    -   524 second string insertion hole    -   6 control wire pulling-out mechanism (contracted state keeping        wire pulling-out mechanism)    -   61 control wire pulling-out window (contracted state keeping        wire pulling-out window)    -   62 control wire pulling-out string (contracted state keeping        wire pulling-out string)    -   7 engaging wire pulling-out mechanism (mounted state keeping        wire pulling-out mechanism)    -   71 engaging wire pulling-out window (mounted state keeping wire        pulling-out window)    -   72 engaging wire pulling-out string (mounted state keeping wire        pulling-out string)    -   8 holding device    -   81 holding tube

1. A stent graft transport device comprising: a transport tube totransport a stent graft; and a mounting mechanism to mount the stentgraft on the transport tube, wherein the mounting mechanism comprises amounted state keeping wire that keeps a mounted state of the stent grafton the transport tube, and the transport tube can be separated from thestent graft by releasing the mounted state with an operation of pullingan operation end part of the mounted state keeping wire, the operationend part of the mounted state keeping wire is housed inside of thetransport tube, and a mounted state keeping wire pulling-out mechanismto draw the operation end part out of the transport tube comprises amounted state keeping wire pulling-out string, one end part of which ismounted on the mounted state keeping wire and the other end part ofwhich is pulled out from a mounted state keeping wire pulling-out windowarranged on a side peripheral surface of the transport tube.
 2. A stentgraft transport device comprising: a transport tube to transport a stentgraft; and a contraction mechanism to contract the stent graft, whereinthe contraction mechanism comprises a contracted state keeping wire thatkeeps a contracted state of the stent graft, and the stent graft can bein an expanded state by releasing the contracted state of the stentgraft with an operation of pulling an operation end part of thecontracted state keeping wire, the operation end part of the contractedstate keeping wire is housed inside of the transport tube, and acontracted state keeping wire pulling-out mechanism to draw theoperation end part out of the transport tube comprises a contractedstate keeping wire pulling-out string, one end part of which is mountedon the contracted state keeping wire and the other end part of which ispulled out from a contracted state keeping wire pulling-out windowarranged on a side peripheral surface of the transport tube.
 3. Thestent graft transport device described in claim 1, further comprising: acontraction mechanism to contract the stent graft, wherein thecontraction mechanism comprises a contracted state keeping wire thatkeeps a contracted state of the stent graft, and the stent graft can bein an expanded state by releasing the contracted state of the stentgraft with an operation of drawing an operation end part of thecontracted state keeping wire, the operation end part of the contractedstate keeping wire is housed inside of the transport tube, and acontracted state keeping wire pulling-out mechanism to draw theoperation end part out of the transport tube comprises a contractedstate keeping wire pulling-out string, one end part of which is mountedon the contracted state keeping wire and the other end part of which ispulled out from a contracted state keeping wire pulling-out windowarranged on a side peripheral surface of the transport tube.
 4. Thestent graft transport device described in claim 3, wherein the mountedstate keeping wire pulling-out window and the contracted state keepingwire pulling-out window are arranged in a state of being deviated fromeach other in an axial direction of the transport tube.
 5. The stentgraft transport device described in claim 1, wherein the stent graftcomprises a main tube and a branch tube bifurcated from the main tube,and the stent graft transport device is applied to the branch tube. 6.The stent graft transport device described in claim 2, wherein the stentgraft comprises a main tube and a branch tube bifurcated from the maintube, and the stent graft transport device is applied to the branchtube.
 7. The stent graft transport device described in claim 1, thestent graft transport device being configured to transport the stentgraft to a lesion part along a guide wire inserted into a blood vessel,the stent graft transport device further comprising: a posture controlmember that is provided with a through bore through which the guide wireslidably passes in a curved state in one direction, wherein the posturecontrol member is shorter than the stent graft and mounted on a distalend part of the stent graft.
 8. The stent graft transport devicedescribed in claim 2, the stent graft transport device being configuredto transport the stent graft to a lesion part along a guide wireinserted into a blood vessel, the stent graft transport device furthercomprising: a posture control member that is provided with a throughbore through which the guide wire slidably passes in a curved state inone direction, wherein the posture control member is shorter than thestent graft and mounted on a distal end part of the stent graft.
 9. Thestent graft transport device described in claim 7, wherein the posturecontrol member comprises a header and a mounting body that is arrangedcontinuously to a rear end part of the header, the distal end part ofthe stent graft is mounted on the mounting body, and a cross sectionalshape of the mounting body is noncircular.
 10. The stent graft transportdevice described in claim 8, wherein the posture control membercomprises a header and a mounting body that is arranged continuously toa rear end part of the header, the distal end part of the stent graft ismounted on the mounting body, and a cross sectional shape of themounting body is noncircular.